Drug Interaction Report

Tan-Shen and Enoxaparin Injection: Interaction Details

Name: Tan-Shen and Enoxaparin Injection Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Tan-Shen and Enoxaparin Injection interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Enoxaparin Injection

Lovenox Lovenox®

Tan-Shen

No brand names on record

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Aug 8, 2026

Editorial policy · Data sources

Interaction severity

Moderate

Can be significant — usually manageable with monitoring.

Minor

Moderate

Major

Contraindicated

How we grade severity & evidence

Severity levels

Contraindicated: These should generally not be used together.
Major: Potentially serious — often needs a change or close monitoring.
Moderate: Can be significant — usually manageable with monitoring.
Minor: Usually limited clinical impact.

Evidence grades

Established: Well documented — supported by controlled studies or strong clinical data.
Probable: Good supporting evidence, though not definitively proven.
Suspected: Some evidence suggests this interaction, but it is not well established.
Possible: Limited or conflicting evidence; the interaction may occur.
Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 22 documented Tan-Shen interactions, 13 are rated moderate — including this one.

Onset

delayed

Evidence

theoretical

Severity

Moderate

What happens

Increased risk of bleeding

Interaction Deep Dive

Theoretically, additive antiplatelet effects may occur resulting in bleeding complications if tan-shen is used concomitantly with low molecular weight heparins. In vitro, tan-shen extracts alone have shown inhibition of platelet aggregation¹². Human cases with concomitant use of warfarin and tan-shen report greatly elevated International Normalized Ratio (INR) and bleeding complications ³⁴⁵.

Why it happens (mechanism)

Inhibition of cAMP phosphodiesterase by tan-shen may result in additive antiplatelet effects

Common questions

Can I take Tan-Shen and Enoxaparin Injection together?

Increased risk of bleeding Always confirm with your pharmacist or prescriber before making any change.

How serious is the Tan-Shen and Enoxaparin Injection interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

Does my dose of Tan-Shen or Enoxaparin Injection need adjusting while I take them together?
What symptoms should prompt me to call you or my prescriber right away?
Does the timing of my doses matter for this combination?
Is there anything you'd monitor while I'm on both?

References (5)

Onitsuka M, Fujui M, Shinma N, et al: New platelet aggregation inhibitors from tan-shen; radix of Salvia miltiorrhiza Bunge. Chem Pharm Bull 1983; 31(5):1670-1675. PubMed
Wang Z, Roberts JM, Grant PG, et al: The effect of a medicinal Chinese herb on platelet function. Thromb Haemostas 1982; 48(3):301-306. DOI
Izzat MB, Yim APC, & El-Zufari H: A taste of Chinese medicine. Ann Thorac Surg 1998; 66:941-942. PubMed
Yu CM, Chan JCN, & Sanderson JE: Chinese herbs and warfarin potentiation by danshen. J Intern Med 1997; 241:337-339. PubMed
Tam LS, Chan TYK, Leung WK, et al: Warfarin interactions with Chinese traditional medicines: danshen and methyl salicylate medicated oil. Aust NZ J Med 1995; 25:258. PubMed

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Enoxaparin Injection

Keep reading about Enoxaparin Injection

All Enoxaparin Injection interactions (177) Enoxaparin Injection drug information

Also serious with: Defibrotide Zanubrutinib Proquazone Propyphenazone

Tan-Shen

Keep reading about Tan-Shen

All Tan-Shen interactions (22)

Also serious with: Defibrotide Injection Fondaparinux Fondaparinux Injection Heparin

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HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

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